Strabismus Clinical Trial
Official title:
Effect of Neuromuscular Blockade on the Oculomotor by Not Squinting Child
Strabismus is a common condition (4-6% of the population) . The screening and treatment is a
public health issue. Indeed, beyond the disfigurement, this disease is very supplier of
amblyopia which is definitive if it is not detected and treated early (before 6 years old).
Initial treatment of strabismus is medical with orthoptic reeducation through penalization
of the better eye in case of amblyopia or wearing optical correction in case of associated
refractive disorder.
The second step is the treatment of strabismus is the surgery, when medical treatment has
not resulted in a recovery of the visual axes. The principle of surgery is to weaken or
strengthen one or more extraocular muscles of one (or two) eye to correct the eyes squint
deviation. The main difficulty of surgical treatment is to assess the amount of
strengthening or weakening muscles to do in order to obtain the best result and for a long
time.
The investigators know that the postmortem anatomical position of the eyes is generally a
slight elevation and divergence, but is inferior to the angle of divergence of the orbital
axes. Curare and similar products which inhibit the nervous transmission at the
neuromuscular junction, can be used to reproduce this situation in normal subjects.
The sign of general anesthesia is then to evaluate the angle of strabismus when the patient
is under deep general anesthesia and with a complete muscle relaxation, obtained only when
curarised it. If one or both eyes are recovering under general anesthesia, strabismus is
mainly due to dynamic changes and surgery limiting muscle play (wire operation) and
sometimes one eye is justified. A combination of both is possible (down + wireless), guided
by the importance of the sign of general anesthesia on two prominent eyes or one eye. This
sign of general anesthesia is however less known and most poorly quantified in healthy
subjects. Yet it seems very important to determine what is deviation in normal subjects
after neuromuscular blockade, as his eye movement is also subject to mechanical factors and
spastic. This would indicate whether the state of rectitude (no strabismus) is the result of
a deviation at complete rest (appearing under general anesthesia) and corrected by spastic
elements wakefulness or, in another case this righteousness is already present in the state
of general anesthesia (due to static factors) and slightly modified by enlightenment.
n/a
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